Achieving the right level of care in HNHB
The term “Alternative Level of Care” or ALC is used to describe hospitalized patients who no longer require acute care and are waiting for transfer to another type of care. Recent studies of the flow of patients across the entire healthcare continuum reveal that there are patients in other health care settings, such as Complex Continuing Care and Rehabilitation, who require a different level of care because their care needs have changed -- they require the right level of care.
ALC is not solely a hospital problem but a reflection of the challenges associated with transitioning across the system. ALC is about flow and system performance. Reducing the number of ALC patients is critical to solving our challenges associated with emergency department overcrowding, prolonged ambulance offloading times, elective surgical cancellations and acute care bed availability. It also about making sure we are servicing people in the right care environment.
While viewed as an important indicator of health system performance, ALC is most importantly an issue that affects patients and their families. Many ALC patients find themselves waiting in the hospital faced with important decisions regarding their longer term care needs. This can be a stressful time for patients and families. While hospitals provide safe, high quality care, patients waiting for alternate level of care may be at risk of hospital acquired illness and deterioration in physical, mental and social functioning.
There is no quick fix for ALC issues, and no one solution will resolve the problem. Building the necessary capacity in the community and prevention measures will take time to realize their potential. ALC challenges are a complex system issue and solutions require partnership and collaboration between patients, families and providers across the health care continuum.
There are many projects currently underway across HNHB designed to address ALC pressures; the overarching strategy is managed by an ALC Steering Committee. This Committee is comprised of decision makers from across the Hamilton Niagara Haldimand Brant (HNHB) Local Health Integration Network (LHIN) and across care sectors, including, hospitals, Community Care Access Centre (HNHB CCAC), long term care homes (LTCH) and Community Support Services (CSS) and retirement homes. The purpose of the Committee is to identify and support strategies that will improve access to appropriate levels of care for those in our communities.
The Committee’s activities and strategic directions are described in their Strategic Plan.
updated November 5, 2009